Development, Translation and Validation of Enhanced Asian Rome III Questionnaires for Diagnosis of Functional Bowel Diseases in Major Asian Languages: A Rome Foundation-Asian Neurogastroenterology and Motility Association Working Team Report

Background/AimsThe development-processes by regional socio-cultural adaptation of an Enhanced Asian Rome III questionnaire (EAR3Q), a cultural adaptation of the Rome III diagnostic questionnaire (R3DQ), and its translation-validation in Asian languages are presented. As English is not the first language for most Asians, translation-validation of EAR3Q is essential. Hence, we aimed to culturally adapt the R3DQ to develop EAR3Q and linguistically validate it to show that the EAR3Q is able to allocate diagnosis according to Rome III criteria.MethodsAfter EAR3Q was developed by Asian experts by consensus, it was translated into Chinese, Hindi-Telugu, Indonesian, Korean, and Thai, following Rome Foundation guidelines; these were then validated on native subjects (healthy [n = 60], and patients with irritable bowel syndrome [n = 59], functional dyspepsia [n = 53] and functional constipation [n = 61]) diagnosed by clinicians using Rome III criteria, negative alarm features and investigations.ResultsExperts noted words for constipation, bloating, fullness and heartburn, posed difficulty. The English back-translated questionnaires demonstrated concordance with the original EAR3Q. Sensitivity and specificity of the questionnaires were high enough to diagnose respective functional gastrointestinal disorders (gold standard: clinical diagnoses) in most except Korean and Indonesian languages. Questionnaires often uncovered overlapping functional gastrointestinal disorders. Test-retest agreement (kappa) values of the translated questionnaires were high (0.700–1.000) except in Korean (0.300–0.500) and Indonesian (0.100–0.400) languages at the initial and 2-week follow-up visit.ConclusionsThough Chinese, Hindi and Telugu translations were performed well, Korean and Indonesian versions were not. Questionnaires often uncovered overlapping FGIDs, which were quite common

Prevalence, awareness and control of hypertension in rural areas in Selangor and Perak

Abstract The aim of this study was to describe the prevalence, awareness and control of hypertension in the rural population of Perak and Selangor. Methods This was a population based cross-sectional study involving subjects in Kuala Selangor, Tanjung Karang and Bidor. The World Health Survey Kish tables were used to select eligible subject (≥18 years old) from each selected household. A Case Report Form (CRF) was used to record their social demography, past medical history, anthropometry measurement and blood pressure (BP). Hypertension was defined as a blood pressure > 140/90 mmHg. Hypertension controlled was defined as a blood pressure of < 140/90 mmHg. Results A total of 761 people participated in this study. Of which 287 (37.8%) were males and 473 (62.2%) were females. Out of this, 271 (35.6%) were hypertensive. The study showed 36 (4.7%) subjects were not aware that they have hypertension. Only 76% of hypertensive subjects were on HPT medication. One hundred and five (51%) subjects were on monotherapy, 66 (32%) were on dual therapy, 27 (13.1%) on triple therapy, 8 (3.9%) were on more than 3 medications. 73 (26.9%) of the hypertensive subjects were not on any HPT medications having a SBP of 133.9 +/- 17 and DBP of 86.2 +/- 49.3

Development, Translation and Validation of Enhanced Asian Rome III Questionnaires for Diagnosis of Functional Bowel Diseases in Major Asian Languages: A Rome Foundation-Asian Neurogastroenterology and Motility Association Working Team Report

BACKGROUND/AIMS: The development-processes by regional socio-cultural adaptation of an Enhanced Asian Rome III questionnaire (EAR3Q), a cultural adaptation of the Rome III diagnostic questionnaire (R3DQ), and its translation-validation in Asian languages are presented. As English is not the first language for most Asians, translation-validation of EAR3Q is essential. Hence, we aimed to culturally adapt the R3DQ to develop EAR3Q and linguistically validate it to show that the EAR3Q is able to allocate diagnosis according to Rome III criteria. METHODS: After EAR3Q was developed by Asian experts by consensus, it was translated into Chinese, Hindi-Telugu, Indonesian, Korean, and Thai, following Rome Foundation guidelines; these were then validated on native subjects (healthy [n = 60], and patients with irritable bowel syndrome [n = 59], functional dyspepsia [n = 53] and functional constipation [n = 61]) diagnosed by clinicians using Rome III criteria, negative alarm features and investigations. RESULTS: Experts noted words for constipation, bloating, fullness and heartburn, posed difficulty. The English back-translated questionnaires demonstrated concordance with the original EAR3Q. Sensitivity and specificity of the questionnaires were high enough to diagnose respective functional gastrointestinal disorders (gold standard: clinical diagnoses) in most except Korean and Indonesian languages. Questionnaires often uncovered overlapping functional gastrointestinal disorders. Test-retest agreement (kappa) values of the translated questionnaires were high (0.700–1.000) except in Korean (0.300–0.500) and Indonesian (0.100–0.400) languages at the initial and 2-week follow-up visit. CONCLUSIONS: Though Chinese, Hindi and Telugu translations were performed well, Korean and Indonesian versions were not. Questionnaires often uncovered overlapping FGIDs, which were quite common

Prevalence of elevated aldosterone renin ratio in three main states of Peninsular Malaysia

Objective: The objective of this study was to determine the prevalence of increased Aldosterone Renin Ratio (ARR) in parts of Selangor, Perak and Pahang. Methods: This was a cross sectional study involving subjects in Selangor, Perak and Pahang. The World Health Survey Kish tables were used to select eligible subjects (≥18 years old) from each household. Their social demography, past medical history, anthropometric measurement and blood pressure were recorded. Blood were withdrawn for Aldosterone (ALD), Plasma Renin Activity (PRA), Creatinine (creat) and potassium (K). Raised ARR is defined as aldosterone/renin ratio of more than 20. Results: A total of 1073 subjects (age 50 +/- 16.4). One hundred and nineteen (11.1%) subjects showed an ARR =/> 20. Forty nine (41.2%) out of the elevated ARR =/> 20 were hypertensive, 11 of which were not taking any anti-hypertensive drugs and 54 subjects (45.4%) were normotensive. Only 7 (5.9%) of them were hypokalemic, one of them being hypertensive. The main clinical characteristics of subjects with raised ARR are shown in Table 1. Conclusion: The prevalence of raised ARR in Rural Selangor was 11.1%, and only 5.9% of them were hypokalemic